The sternocleidomastoid flap--its indications and limitations

Area of Science:

• Plastic Surgery
• Head and Neck Surgery
• Reconstructive Surgery

Background:

• The sternocleidomastoid (SCM) flap is a versatile surgical technique for head and neck reconstruction.
• Its utility and reliability compared to other reconstructive options are not fully established.

Purpose of the Study:

• To evaluate the sternocleidomastoid (SCM) flap as a reconstructive option in head and neck surgery.
• To determine specific situations where the SCM flap offers a reliable alternative to other surgical techniques.

Main Methods:

• A comprehensive meta-analysis of existing literature on the SCM flap was conducted.
• Literature review focused on indications, success rates, and complication profiles of different SCM flap variations.

Main Results:

• Four SCM flap types exist: muscle, myocutaneous, myoperiosteal, and osteomuscular, with varying complication rates (11% for muscle, 21% for myocutaneous, 4% for osteomuscular, 6% for myoperiosteal).
• Applications range from fistula closure and soft tissue reconstruction to facial reanimation and complex laryngotracheal reconstruction.
• The SCM myocutaneous flap is most common, while the osteomuscular flap shows the lowest complication rate.

Conclusions:

• The SCM flap is a practical reconstructive tool for select head and neck defects.
• Its successful application depends on careful patient selection and adherence to specific surgical precautions.
• Further research may refine indications for optimal outcomes in head and neck reconstruction.